Provider Demographics
NPI:1548524085
Name:KOKOMO CAB LLC
Entity type:Organization
Organization Name:KOKOMO CAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-868-3333
Mailing Address - Street 1:1015 S. WASHINGTON ST.
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902
Mailing Address - Country:US
Mailing Address - Phone:765-868-3333
Mailing Address - Fax:765-868-3980
Practice Address - Street 1:1015 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-6346
Practice Address - Country:US
Practice Address - Phone:765-868-3333
Practice Address - Fax:765-868-3980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN511LFH343900000X
IN509LFH343900000X
IN512LFH343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)